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硬膜外阻滞时罗哌卡因和布比卡因的药代动力学
Hemodynamics and stress response changes during laparoscopic cholecystectomy under general anesthesia or combination of general and epidural anesthesia
【摘要】 目的 研究国人在硬膜外阻滞时罗哌卡因和布比卡因的药代动力学特征。方法 选择14 例手术病人、随机分为两组。硬膜外阻滞时,分别注入罗哌卡因2.0m g/kg 或布比卡因2.0m g/kg。用气相色谱法测定血浆药物浓度。结果 罗哌卡因和布比卡因的药-时曲线均符合二室开放模型。t1/2ka分别为0.22 小时和0.14 小时,Tpeak 分别为0.51 小时和0.47 小时,Cam x 分别为1.06m g·L- 1和1.44m g·L- 1 。另外发现,其主要药代动力学参数,AUC分别为2.6m g·L- 1·h- 1 和5.2m g·L- 1·h- 1 ,t1/2 β分别为1.7 小时和2.8 小时,CL分别为757m l·m in- 1 和382m l·m in- 1,两组间均具有显著差异(P< 0.05)。结论 罗哌卡因比布比卡因较少发生中枢神经系统及心血管的蓄积,主要是由于罗哌卡因在体内消除代谢能力较强所致。
【Abstract】 Objective To observe the hemodynamic and concentration of plasma catecholamines changes during laparoscopic cholecystectomy (LC) under general anesthesia or combined with epidural anesthesia Methods Twenty patients,scheduled for LC,were randomly divided into general anesthesia group (A group,n=11) and general anesthesia combined with epidural anesthesia group (B group,n=9) The hemodynamic changes after peritoneal insufflation of CO 2 were measured with Swan Ganz catheterization,and the plasma concentration of epinepherine (E) and nonepinepherine (NE) were measured before and after CO 2 being insufflated into peritoneal cavity with high performance liquid chromatography electrochemical method Results (1) Both concentraitons of NE and E were increased significantly after peritoneal insufflation in A group (P<0 05),while no obvious changes in B group (P>0 05) (2)HR,MAP,CVP,SVR and CI were increased significantly while SV had no obvious change after peritoneal insufflation in A group; in B group, all parameters had no significant changes except CVP was significantly increased Conclusion The combination of general and epidural anesthesia can suppress the stress response and stablize the hemodynamics during LC
【Key words】 Ansthesia; general Anesthesia; epidural Cholecystectomy; laparoscopic Hemodynamics Stress;
- 【文献出处】 中华麻醉学杂志 ,CHINESE JOURNAL OF ANESTHESIOLOGY , 编辑部邮箱 ,1999年08期
- 【被引频次】44
- 【下载频次】200